Chronic Illness Self-Management While Living Alone in Later Life: A Systematic Integrative Review

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The Issue

Older adults living on their own are a vulnerable and growing health care population. In addition to lacking social support and financial security, they often contend with complex multiple chronic conditions and limitation in physical mobility. Little is known about the capacity of this population to manage their health conditions, or how best to provide tailored support.

What the Study Found

For their study, 2008–09 Commonwealth Fund Harkness Fellow Jörg Haslbeck and colleagues reviewed 32 academic studies focused on the challenges that older people living alone face, their strategies for maintaining independence, and their ability to manage their health conditions. According to the review, these individuals cherish their independence and ability to make their own decisions. Many try to remain in their own homes as long as possible, finding creative ways to deal with their limitations. Yet many struggle with fragile living situations, limited resources, and inadequate social support—leaving them vulnerable to health complications that could jeopardize their ability to remain at home.

Conclusions

The desire for independence later in life meshes with trends in health policy and practice that favor supporting patients in their efforts to manage their own health conditions. But to be most effective, self-management approaches must be tailored to the needs of older people living alone—in particular, the needs of men within this group, which has received little research or policy attention.